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HOS Exam 2
Flash cards for exam 2.
949
Physiology
Professional
02/27/2013

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Term
What cells line the entire lumen of the cardiovascular system
Definition
Endothelial
Term
Cardiac output =
Definition
CO = heart rate (HR) * stroke volume (SV)
Term
Flow =
Definition
Flow = Pressure (P) / Resistance (R)
Term
Determinant of cardiac output: name for blood returning to heart
Definition
Preload
Term
Determinant of cardiac output: vasculature resistance
Definition
Afterload
Term
__% blood volume in heart and lungs
Definition
15%
Term
__% blood volume in arteries
Definition
10%
Term
__% blood volume in capillaries
Definition
5%
Term
__% blood volume in veins
Definition
70%
Term
Cells that make up the epicardium
Definition
Mesothelial
Term
Which layer of the heart is continuous with the endothelium of vessels
Definition
Endocardium
Term
Fibrous skeleton of the heart (3)
Definition
1) Annuli fibrosi, 2) trigona fibrosi, 3) septum membranaceum
Term
Main metabolic fuel of cardiomyocytes
Definition
Lipids
Term
Cardiomyocytes: anaerobic or aerobic metabolism
Definition
Aerobic
Term
Atrial granules contain what
Definition
Atrial natriuretic peptide (ANP)
Term
Atrial natriuretic peptide leads to what (3)
Definition
1) Diuresis, 2) Na excretion, 3) vasodilation
Term
Fibrous skeleton contains what collagens (2)
Definition
1) Type I, 2) Type III
Term
Name for the collagen joining capillaries and cardiomyocytes
Definition
Collagen struts
Term
Major coronary circulation vessels found in: endocardium or epicardium
Definition
Epicardium
Term
Name for arteries that penetrate through myocardium
Definition
Transmural arteries/arterioles
Term
Majority of transmural blood flow occurs during: systole or diastole
Definition
Diastole
Term
Connections between major arteries
Definition
Collaterals
Term
Ischemia vs. infarction
Definition
Infarction is cell death; ischemia is hypoperfusion and not permanent
Term
Atherosclerosis progression (3)
Definition
Fatty streak → fibrosis → calcification
Term
Development of ischemia may induce creation of
Definition
Collaterals
Term
Pacemaker of the heart aka
Definition
Sino-atrial node
Term
Slowest conducting part of the heart
Definition
AV node
Term
Conduction system from SA node (6)
Definition
SA node → internodal fibers → AV node → bundle of His → bundle branches → Purkinje fibers
Term
P wave =
Definition
Depolarization of the atria
Term
Depolarization of the atria = ___ wave
Definition
P wave
Term
QRS complex =
Definition
Depolarization of the ventricles
Term
Depolarization of the ventricles = ___ complex
Definition
QRS complex
Term
Q wave =
Definition
Depolarization of the septum
Term
Depolarization of the septum =
Definition
Q wave
Term
R wave =
Definition
Depolarization of the apex
Term
Depolarization of the apex =
Definition
R wave
Term
S wave =
Definition
Depolarization of the ventricle walls
Term
Depolarization of the ventricle walls =
Definition
S wave
Term
T wave =
Definition
Repolarization of the ventricles
Term
SNS fibers to the heart are what kind
Definition
Adrenergic
Term
PSNS fibers to the heart are what kind
Definition
Cholinergic
Term
Layers of blood vessels (3; deep to superficial)
Definition
1) Tunica intima, 2) tunica media, 3) tunica adventitia
Term
Why do some arteries have vaso vasorum
Definition
They are too thick to be perfused from blood in the lumen
Term
Blockage of vaso vasorum can lead to what condition
Definition
Aneurysm
Term
Vasodilators (4)
Definition
1) NO, 2) prostacyclin, 3) EDHF, 4) adenosine
Term
Vasoconstrictors (3)
Definition
1) Angiotensin II, 2) thromboxane A2, 3) endothelin
Term
What about endothelium keeps platelets away
Definition
Endothelium is negatively charged
Term
Endothelia produce what pro-coagulant factor
Definition
von Willebrand factor (vWF)
Term
Cells that exist on top of capillaries that can differentiate into smooth muscle
Definition
Pericytes
Term
α and β adrenergic receptors: synergistic or antagonistic
Definition
Antagonistic: they oppose each other's actions
Term
Epinepherine on β-adrenergic receptors: vasodilation or vasoconstriction
Definition
Vasodilation
Term
Epinepherine on α-adrenergic receptors: vasodilation or vasoconstriction
Definition
Vasoconstriction
Term
Short connection between arteriole and venule is an
Definition
AV shunt
Term
Long connection between arteriole and venule is a
Definition
Metarteriole
Term
Why is there pressure in the aorta after the aortic valve closes
Definition
Elasticity in the aorta maintains creates the diastolic pressure
Term
Steps of angiogenesis (4)
Definition
Disintegration of basement membrane → cell migration → cell proliferation → new basement membrane
Term
Atherosclerosis most likely in which arteries (2)
Definition
1) Coronaries, 2) carotids
Term
Arteriosclerosis
Definition
Hardening of arteries
Term
Varicose veins
Definition
Defective vein valves; reversed flow
Term
Types of capillaries (4)
Definition
1) Continuous, 2) continuous in CNS, 3) fenestrated, 4) sinusoidal
Term
Which capillary type has zonula occludens junctions
Definition
Continuous in CNS
Term
Which capillary type has large gaps
Definition
Sinusoidal
Term
Transcapillary exchange methods (4)
Definition
1) Transcellular, 2) transcytosis, 3) intercellular, 4) vesicular channel
Term
Which transcapillary exchange method for gases
Definition
Transcellular
Term
Which transcapillary exchange method for ions
Definition
Intercellular
Term
Which transcapillary exchange method for macromolecules (2)
Definition
1) Transcytosis, 2) vesicular channels
Term
Do lymphatics have well-developed basal lamina: yes or no
Definition
No
Term
Depolarization of the entire heart takes __ msec
Definition
200-220 milliseconds
Term
Fastest conducting part of the heart
Definition
Purkinje fibers
Term
Slowest conducting part of the heart
Definition
AV node
Term
Channels contributing to resting membrane potential of cardiomyocytes (2)
Definition
1) Na-K pump, 2) potassium leak
Term
Why is the Na-K pump electrogenic
Definition
3 Na out for 2 K in = net 1 cation out of the cell
Term
Hyperkalemia will ___ [increase or decrease] resting membrane potential
Definition
Increase
Term
Permeability of which ion dominates a resting cardiomyocyte
Definition
Potassium
Term
In the Hodkin-Huxley model, an "m" gate corresponds to which: activating or inactivating gate
Definition
Activating gate
Term
In the Hodkin-Huxley model, an "h" gate corresponds to which: activating or inactivating gate
Definition
Inactivating gate
Term
Phases of a fast-type action potential starting from resting membrane
Definition
4 → 0 → 1 → 2 → 3 → 4
Term
Phases of a slow-type action potential starting from resting membrane
Definition
4 → 0 → 3 → 4
Term
Fast action potential: phase 0 consists on which ions
Definition
Na & Ca
Term
Fast action potential: phase 1 consists on which ions
Definition
Na closes, transient-outward K open (Ito)
Term
Fast action potential: phase 2 consists on which ions
Definition
T-type Ca close, L-type open still
Term
Fast action potential: phase 3 consists on which ions
Definition
Increase K, closure of Ca
Term
Fast action potential: phase 4 consists on which ions
Definition
K & Na
Term
Slow action potential: phase 0 consists on which ions
Definition
Ca only
Term
Slow action potential: phase 1 consists on which ions
Definition
None, there is no phase 1 in slow AP's
Term
Slow action potential: phase 2 consists on which ions
Definition
None, there is no phase 2 in slow AP's
Term
Slow action potential: phase 3 consists on which ions
Definition
Increase K, closure of Ca
Term
Slow action potential: phase 4 consists on which ions
Definition
K, Ca, and cations of the funny current (If)
Term
Modifications to action potentials to decrease heart rate at SA node (3)
Definition
1) Decrease phase 0 slope, 2) increase threshold potential, 3) decrease maximal diastolic potential
Term
Normal pacemaker rate of the SA node
Definition
60-100 bpm
Term
Normal pacemaker rate of the AV node
Definition
40-50 bpm
Term
Normal pacemaker rate of the ventricular pacemakers
Definition
< 40 bpm
Term
Increasing the potassium in the ECF has what effects on action potentials (2)
Definition
1) Resting membrane is less negative, 2) amplitude decreases
Term
Syncytium is created through what junction
Definition
Gap junctions
Term
Why are Purkinje fibers made up of big cells
Definition
Increased conduction velocity
Term
Name the period from start of phase 1 to when any sort of action potential can be forcably stimulated
Definition
Absolute/effective refractory period
Term
Name the period when a small number of Na channels have recovered and can be stimulated
Definition
Absolute/effective refractory period
Term
Name the period from when any sort of action potential can be created to when a full/normal AP can be created
Definition
Relative refractory period
Term
Name the period when all the Na channels have recovered
Definition
Relative refractory period
Term
Do SA node (or AV node) cells have few or abundant gap junctions
Definition
Very few gap junctions
Term
Which cells of the heart have the main function of pacemaker
Definition
SA node & AV node
Term
Which cells of the heart have the main function of contractility
Definition
Atrial & ventricular myocytes
Term
Which cells of the heart have the main function of rapid conduction
Definition
His bundle, bundle branches, and Purkinje fibers
Term
Portion of ECG that represents atrial depolarization
Definition
P wave
Term
Portion of ECG that represents ventricular depolarization
Definition
QRS complex
Term
Portion of ECG that represents ventricular repolarization
Definition
T wave
Term
Portion of ECG that represents atrial repolarization
Definition
Never talkeda about this, but it's masked by the QRS complex
Term
Convention: 1 small horizontal box = __ mm = __ sec
Definition
1 small box = 1 mm = 0.05 sec
Term
Convention: 1 big horizontal box = __ mm = __ sec
Definition
1 big box = 5 mm = 0.2 sec
Term
Convention: 1 small vertical box = __ mm = __ mV
Definition
1 small box = 1 mm = 0.1 mV
Term
Convention: 1 big vertical box = __ mm = __ mV
Definition
1 big box = 5 m = 0.5 mV
Term
Period in which almost all ventricular myocytes are depolarized
Definition
ST segment
Term
Period that is largely conduction through the AV node
Definition
PR interval
Term
Period that indicates good conduction through the His-Purkinje system
Definition
QRS interval
Term
Period that correlates with the mean AP duration of the ventricular myocytes
Definition
QT interval
Term
Ventricular septum depolarizes: left-to-right or right-to-left
Definition
Left-to-right
Term
Ventricle depolarizes: endo-to-epicardium or epicardium-to-endocardium
Definition
From the endocardium toward the superficial epicardium
Term
Which is last to depolarize: left or right ventricle
Definition
Left ventricle
Term
Why does the mean QRS vector point to the left if both ventricles depolarize at the same time
Definition
The left has more mass
Term
What two factors cause the T wave to have the same polarity as the R wave
Definition
1) Repolarization has the opposite charge, 2) repolarization happens in reverse direction of depolarization
Term
Lead I points from ___ to ___
Definition
From right arm to left arm
Term
Lead II points from ___ to ___
Definition
From right arm to left leg
Term
Lead III points from ___ to ___
Definition
From left arm to left leg
Term
Which lead points from right arm to left arm
Definition
Lead I
Term
Which lead points from right arm to left leg
Definition
Lead II
Term
Which lead points from left arm to left leg
Definition
Lead III
Term
Limb leads are: bipolar or unipolar
Definition
Bipolar
Term
A positive deflection on an ECG indicates what of the electrical vector with respect to the electrode
Definition
Both are in the same direction
Term
A negative deflection on an ECG indicates what of the electrical vector with respect to the electrode
Definition
They are in opposite directions
Term
An isoelectric deflection on an ECG indicates what of the electrical vector with respect to the electrode
Definition
They are perpendicular to each other
Term
Which are the limb leads
Definition
I, II, III
Term
Which are the augmented leads
Definition
aVR, aVL, aVF
Term
Which are the precordial leads
Definition
V1, V2, V3, V4, V5, V6
Term
Lead aVF points from ___ to ___
Definition
Heart to foot
Term
Lead aVR points from ___ to ___
Definition
Heart to right arm
Term
Lead aVL points from ___ to ___
Definition
Heart to left arm
Term
According to the hexaxial circle, what vector is at 0°
Definition
#NAME?
Term
According to the hexaxial circle, what vector is at 30°
Definition
#NAME?
Term
According to the hexaxial circle, what vector is at 60°
Definition
#NAME?
Term
According to the hexaxial circle, what vector is at 90°
Definition
#NAME?
Term
According to the hexaxial circle, what vector is at 120°
Definition
#NAME?
Term
According to the hexaxial circle, what vector is at 150°
Definition
#NAME?
Term
According to the hexaxial circle, what vector is at 180°
Definition
#NAME?
Term
According to the hexaxial circle, what vector is at -30°
Definition
#NAME?
Term
According to the hexaxial circle, what vector is at -60°
Definition
#NAME?
Term
According to the hexaxial circle, what vector is at -90°
Definition
#NAME?
Term
According to the hexaxial circle, what vector is at -120°
Definition
#NAME?
Term
According to the hexaxial circle, what vector is at -150°
Definition
#NAME?
Term
Normal range for the QRS axis
Definition
-30° to +90°
Term
If both leads I & II are positive, what can you say about the QRS axis
Definition
It is within the normal range
Term
Some particular lead is isoelectric, what can you say about the QRS axis
Definition
It is perpendicular to that particular lead
Term
V1 is placed where
Definition
Right sternal border of the 4th intercostal space
Term
V2 is placed where
Definition
Left sternal border of the 4th intercostal space
Term
V4 is placed where
Definition
Midclavicular line of the 5th intercostal space
Term
V3 is placed where
Definition
Between V2 & V4
Term
V6 is placed where
Definition
Midaxillary line of the 5th intercostal space
Term
V5 is placed where
Definition
Between V4 & V6
Term
Wiggers' diagram: name of the phase when both valves are closed and during systole
Definition
Isovolumetric contraction
Term
Wiggers' diagram: name of the phase when both valves are closed and during diastole
Definition
Isovolumetric relaxation
Term
Wiggers' diagram: name of the phase when semilunar valve is open
Definition
Ventricular ejection
Term
Wiggers' diagram: name of the phase when AV valve is open
Definition
Ventricular filing
Term
Wiggers' diagram: dicrotic notch demarcates what two phases
Definition
Ventricular ejection & isovolumetric relaxation
Term
During ventricular ejection & filling, when does most of the blood get moved
Definition
During the initial part of that phase [initial is rapid then tapers]
Term
Wiggers' diagram: name of the phase when you would see the T wave on an ECG
Definition
Ventricular ejection
Term
Wiggers' diagram: name of the phase when you would see the QRS complex on an ECG
Definition
R wave separates ventricular filling & isovolumetric contraction
Term
Wiggers' diagram: name of the phase when you would see the P wave on an ECG
Definition
Ventricular filling
Term
How are the L-type Ca channels in cardiac muscle different from skeletal muscle
Definition
They are not mechanically linked to ryanodine receptors
Term
Calcium-induced calcium release means what
Definition
Calcium influx from L-type channels induces ryanodine receptors to open to release calcium
Term
Paths of intracellular calcium efflux (4)
Definition
1) SERCA, 2) Ca-ATPase, 3) Na-Ca exchanger, 4) mitochondria
Term
Na-Ca exchanger relies on what other pump to function correctly
Definition
Na-K pump
Term
Dephosporylation of phospholamban does what
Definition
Inhibits SERCA
Term
For a given sarcomere length, which has more passive tension: cardiac or skeletal muscle
Definition
Cardiac
Term
Cardiomyocytes operate at ___ [shorter or longer] sarcomere lengths relative to optimal length
Definition
Shorter lengths
Term
Preload refers to what structurally of the myocyte
Definition
Initial sarcomere length
Term
Afterload refers to what
Definition
Force that must be overcome
Term
Intrinsic contractility
Definition
Contractile performance of the myocyte itself [excludes, for example, preload & afterload]
Term
Ejection fraction =
Definition
EF = (EDV - ESV) / EDV
Term
Increasing contractility moves the starting diastolic volume which way
Definition
Left, so toward a smaller volume
Term
Decreasing contractility moves the starting diastolic volume which way
Definition
Right, so toward a larger volume
Term
Increasing preload moves the EDV which way
Definition
Right, so toward a larger volume
Term
Decreasing preload moves the EDV which way
Definition
Left, so toward a smaller volume
Term
Increasing afterload moves the starting diastolic volume which way
Definition
Right, so toward a larger volume
Term
Decreasing afterload moves the starting diastolic volume which way
Definition
Left, so toward a smaller volume
Term
Total work performed during one beat =
Definition
E=PV + 1/2*m*v*v + k*T*Δt
Term
Which component of total work is the largest and is about __% of total work
Definition
Tension heat is about 97% of total work
Term
Staircase phenomenon is fundamentally about
Definition
Intracellular [Ca2+]
Term
Post-extrasystolic potential
Definition
An increase in contraction of the beat after a premature ventricular contraction
Term
Post-extrasystolic potential is due to (2)
Definition
1) Frank-Starling mechanism, 2) intracellular [Ca2+]
Term
Extra time after a PVC and before the next contraction is called the
Definition
Compensatory pause
Term
PSNS to the heart via
Definition
CN X
Term
SNS to the heart via
Definition
Sympathetic chain
Term
SNS releases the ___ neurotransmitter which acts on the ___ receptor (be specific)
Definition
NE which acts on β1-adrenergic
Term
PSNS releases the ___ neurotransmitter which acts on the ___ receptor (be specific)
Definition
ACh which ats on the M2-muscarinic
Term
β1 and M2 receptors are
Definition
G protein-coupled receptors
Term
Which activates adenylyl cyclase: β1 or M2
Definition
β1
Term
Which inactivates adenylyl cyclase: β1 or M2
Definition
M2
Term
Chronotrpy affects
Definition
Heart rate
Term
Dromotropy affects
Definition
Conduction velocity
Term
Inotropy affects
Definition
Contractility
Term
Lusitropy affects
Definition
Relaxation
Term
Adenylyl cyclase increase concentration of ___ that activates ___
Definition
cAMP activate PKA
Term
PKA has what targets (3)
Definition
1) L-type Ca channels, 2) phospholamban, 3) TnI
Term
Phosphorylation of L-type Ca channels has what effect on Ca flow
Definition
Increases influx → increases contractility
Term
Phosphorylation of phospholamban has what effect on intracellular Ca
Definition
Frees up inhibition of SERCA, so intracellular [Ca] decreases faster
Term
Phosphorylation of TnI has what effect
Definition
Decreases affinity of TnC for Ca → increases relaxation
Term
SNS: peak pressure: increases or decreases
Definition
Increases
Term
SNS: velocity of contraction: increases or decreases
Definition
Increases
Term
SNS: systole duration: lengthens or shortens
Definition
Shortens
Term
SNS: diastole duration: lengthens or shortens
Definition
Lengthens
Term
SNS: ventricular diastolic pressure: increases or decreases
Definition
Decreases
Term
SNS: ventricular EDV: increases or decreases
Definition
Decreases
Term
PSNS has no significant effect on which: SA node, AV node, ventricles
Definition
Ventricles
Term
Atropine
Definition
Muscarinic receptor antagonist
Term
Propranolol
Definition
β-adrenergic receptor antagonist
Term
Giving atropine and propranolol to a heart has what effect
Definition
Restores SA node's 100 bpm rate by blocking SNS & PSNS activity
Term
Which has faster effects on heart rate: SNS or PSNS
Definition
PSNS
Term
What effects does PSNS have on the SA node (3)
Definition
1) Opens K channels, 2) decreases funny current (If), 3) decreases Ica
Term
What effects does PSNS have on the AV node
Definition
Ca channel inhibition
Term
How is the adrenal gland's secretion of EPI different from heart innervation
Definition
Adrenal secretion of EPI is the mechanism by which transplanted hearts increase heart rate
Term
S1 is heard during which Wiggers' diagram phase
Definition
Isovolumetric contraction
Term
S1 is due to
Definition
AV valves closing
Term
S2 is heard during which Wiggers' diagram phase
Definition
Isovolumetric relaxation
Term
S2 is due to
Definition
SL valves closing
Term
S3 is heard during which Wiggers' diagram phase
Definition
Early ventricular filling
Term
S3 is due to
Definition
Tensing of chordae tendinae & AV ring
Term
S4 is heard during which Wiggers' diagram phase
Definition
Late ventricular filling
Term
S4 is due to
Definition
Atrial contraction
Term
Is S1 normally heard in healthy adults: yes or no
Definition
Yes
Term
Is S2 normally heard in healthy adults: yes or no
Definition
Yes
Term
Is S3 normally heard in healthy adults: yes or no
Definition
No
Term
Is S4 normally heard in healthy adults: yes or no
Definition
No
Term
Is S1 normally heard in healthy children: yes or no
Definition
Yes
Term
Is S2 normally heard in healthy children: yes or no
Definition
Yes
Term
Is S3 normally heard in healthy children: yes or no
Definition
Yes
Term
Is S4 normally heard in healthy children: yes or no
Definition
No
Term
If S3 or S4 is heard, it normally is described how
Definition
S3 or S4 gallop
Term
Murmurs are caused by
Definition
Turbulent flow
Term
Valves that do not completely open is called
Definition
Valve stenosis
Term
Valves that do not close properly and let retrograde flow is called
Definition
Regurgitation
Term
Types of systolic murmurs (2)
Definition
1) Aortic stenosis, 2) mitral regurgitation
Term
Aortic stenosis is what kind of murmur
Definition
Ejection murmur
Term
Mitral regurgitation is what kind of murur
Definition
Holosystolic murmur
Term
Mitral regurgitation obscures which heart sound
Definition
S1
Term
Types of diastolic murmurs (2)
Definition
1) Aortic regurgitation, 2) mitral stenosis
Term
Description of an aortic regurgitation
Definition
Decrescendo
Term
Description of a mitral stenosis
Definition
Opening snap with rumbling diastolic murmur
Term
Which heart sound splits in healthy adults
Definition
S2
Term
Which causes the split S2 to widen: inspiration or expiration
Definition
Inspiration
Term
Which causes the "reversed splitting" S2 to widen: inspiration or expiration
Definition
Expiration
Term
Venous pressure wave: a wave is what
Definition
Atrial contraction
Term
Venous pressure wave: av minimum is what
Definition
Relaxation of atria and mitral valve closure
Term
Venous pressure wave: c peak is what
Definition
Early ventricular contraction [causes mitral to bulge into atria]
Term
Venous pressure wave: x descent is what
Definition
Ventricular ejection [causes elongation of atrium & veins]
Term
Venous pressure wave: v peak is what
Definition
Filing of atria against closed mitral valve
Term
Venous pressure wave: y descent is what
Definition
Fall in atrial pressure after mitral valve opening
Term
Swan-Ganz catheter is used for what
Definition
Pulmonary capillary wedge pressure (PCWP)
Term
What does the PCWP attempt to measure
Definition
Left atrial pressure [i.e. preload]
Term
Using a Swan-Ganx catheter, how can you tell when it moves from RA to RV
Definition
Max pressure jumps from 5 mmHg to 20+ mmHg (systolic pressure)
Term
Using a Swan-Ganx catheter, how can you tell when it moves from RV to pulmonary artery
Definition
Minimum pressure jumps from 5 mmHt to 10+ mmHg (diastolic pressure
Term
Using a Swan-Ganx catheter, how can you tell when it moves from pulmonary artery and wedges
Definition
Systolic pressure is lost
Term
Venous pressure wave: what features are recognizable while in the RA with a Swan-Ganz catheter
Definition
a, c, x, v, & y
Term
Venous pressure wave: what features are recognizable while in the RV with a Swan-Ganz catheter
Definition
a
Term
Venous pressure wave: what features are recognizable while wedged with a Swan-Ganz catheter
Definition
a, x, v, & y
Term
Typical pressure in the aorta
Definition
120/70
Term
Typical pressure in the LV
Definition
120/8
Term
Typical pressure in the LA
Definition
8
Term
Typical pressure in the pulmonary artery
Definition
25/8
Term
Typical pressure in the RV
Definition
25/6
Term
Typical pressure in the RA
Definition
2
Term
Fick method is method to estimate what
Definition
Cardiac output
Term
Q = Vdot * O2 / (CA*O2 - CV*O2) is what method
Definition
Fick method
Term
Fick method uses what as an indicator
Definition
Oxygen
Term
Fick method: where is CA*O2 measured
Definition
Any artery
Term
Fick method: where is CV*O2 measured
Definition
Mixed venous, so pulmonary artery
Term
Indicator-dilution method uses what as an indicator
Definition
Dye
Term
Thermodilution method uses what as an indicator
Definition
Cold saline
Term
Large arteries: compliant or not
Definition
Yes
Term
Capillaries: compliant or not
Definition
Not really, but they aren't under much pressure anyway
Term
Veins: compliant or not
Definition
*VERY* compliant
Term
Which blood vessel is where most of the vascular resistance lies
Definition
Arterioles
Term
Systolic pressure is highest in: RV, aorta, large arteries, or small arteries
Definition
Large arteries
Term
Q = (Pi - Po) / R is what law
Definition
Poiseuille's law
Term
Poiseuille's law
Definition
Q = (Pi - Po) / R = ΔP / R
Term
Rigid tube resistance equation
Definition
R = 8*L*η / (π*r^4)
Term
Rigid tube resistance and length: directly or inversely proportional
Definition
Directly proportional
Term
Rigid tube resistance and viscosity: directly or inversely proportional
Definition
Directly proportional
Term
Rigid tube resistance and radius: directly or inversely proportional
Definition
Inversely proportional
Term
Tripling viscosity increases resistance by a factor of ___
Definition
3
Term
Tripling length increases resistance by a factor of ___
Definition
3
Term
Tripling radius increases resistance by a factor of ___
Definition
3^4 = 81
Term
Primary means that vascular resistance is controlled
Definition
Change in radius
Term
More complete equation [don't assum something is near zero] for CO =
Definition
CO = (MAP - RAP) / TPVR
Term
Mean arterial pressure can be increased how (2)
Definition
1) Increase cardiac output, 2) increase TPVR
Term
Normal heart rate
Definition
55-80 bpm
Term
Normal stroke volume
Definition
70-80 mL
Term
Normal cardiac output
Definition
4.0-5.5 L/min
Term
Normal MAP
Definition
85-95 mmHg
Term
R total = what for three resistances R1, R2, R3 in series
Definition
Rt = R1 + R2 + R3
Term
R total = what for three resistances R1, R2, R3 in parallel
Definition
Rt = 1 / (1/R1 + 1/R2 + 1/R3)
Term
In laminar flow, which is the fastest part of the fluid
Definition
Dead center is the fastest (furthest from the walls)
Term
Reynold's number =
Definition
Nr = (v*(2*r)*ρ) / η
Term
Reynold's number and velocity: directly or inversely proportional
Definition
Directly proportional
Term
Reynold's number and radius: directly or inversely proportional
Definition
Directly proportional
Term
Reynold's number and density: directly or inversely proportional
Definition
Directly proportional
Term
Reynold's number and viscosity: directly or inversely proportional
Definition
Indirectly proportional
Term
Anemia is ___ [more or less] likely to have turbulent flow
Definition
More likely
Term
Polycythemia is ___ [more or less] likely to have turbulent flow
Definition
Less likely
Term
Diastolic pressure is achievable in large arteries because they are
Definition
Elastic
Term
Arterial compliance with aging: increases or decreases
Definition
Decreases
Term
Chronic mechanisms/changes that lead to decreased compliance (5)
Definition
1) More collagen, 2) less elastin, 3) endothelial dysfunction, 4) SNS activation, 5) RAS activation
Term
MAP is ____ [fraction] between diastolic and systolic pressures
Definition
3-Jan
Term
Pulse pressure =
Definition
PP = systolic - diastolic
Term
How is arterial pressure indirectly measured
Definition
Sphygmomanometer
Term
How is arterial presusre directly measured
Definition
Catheter with pressure transducer
Term
Decreasing compliance will ___ [increase or decrease] pulse pressure
Definition
Increase
Term
Decreasing compliance will ___ [increase or decrease] systolic pressure
Definition
Increase
Term
Decreasing compliance will ___ [increase or decrease] diastolic pressure
Definition
Decrease
Term
Are smaller arteries ___ [more or less] compliant than larger arteries
Definition
Less compliant than larger arteries
Term
Do arterioles have a pulse pressure
Definition
Yes, but it's very small [visual guess: ~8 mmHg]
Term
Do capillaries have a pulse pressure
Definition
No
Term
Pulse pressure in ascending aort __ [>, =, <] in abdominal aorta
Definition
Ascending < abdominal [31 vs 40 mmHg]
Term
Pulse pressure in ascending aort __ [>, =, <] in radial artery
Definition
Ascending < radial [31 vs. 55 mmHg]
Term
Which is faster: pulse wave or blood flow
Definition
Pulse wave
Term
Decreasing compliance will ___ [increase or decrease] pulse velocity
Definition
Increase
Term
Law of Laplace
Definition
T=Pr/w
Term
If pressure increases, wall tension will
Definition
Increase
Term
If radius increases, wall tension will
Definition
Increase
Term
If wall thickness increases, wall tension will
Definition
Decrease
Term
Why do aneurysms occur in arteries and not capillaries
Definition
Increased radius → increased wall tension
Term
Fick's Law
Definition
J=D*A*(C1-C2)/T
Term
If the diffusion coefficient increases, diffusion will
Definition
Increase
Term
If the surface area increases, diffusion will
Definition
Increase
Term
If the concentration gradient increases, diffusion will
Definition
Increase
Term
If the barrier thickness increases, diffusion will
Definition
Decrease
Term
Major functions of endothelium (3)
Definition
1) Exchange of nutrients & wastes, 2) filtration/resoprtion of fluid, 3) metabolic/paracrine functions
Term
Exchange of nutrients & wastes by endothelium is: diffusion or bulk flow
Definition
Diffusion
Term
Filtration & resorption by endothelium is: diffusion or bulk flow
Definition
Bulk flow
Term
Starling's law of capillaries =
Definition
=k*[(Pc + πi) - (Pi + πc)]
Term
If capillary hydrostatic pressure increases, filtration will
Definition
Increase
Term
If capillary hydrostatic pressure increases, resorption will
Definition
Decrease
Term
If capillary oncotic pressure increases, filtration will
Definition
Decrease
Term
If capillary oncotic pressure increases, resorption will
Definition
Increase
Term
If interstitial hydrostatic pressure increases, filtration will
Definition
Decrease
Term
If interstitial hydrostatic pressure increases, resorption will
Definition
Increase
Term
If interstitial oncotic pressure increases, filtration will
Definition
Increase
Term
If interstitial oncotic pressure increases, resorption will
Definition
Decrease
Term
If arterial pressure increases, hydrostatic pressure will
Definition
Increase
Term
If venous pressure increases, hydrostatic pressure will
Definition
Increase
Term
If arterial resistance increases, hydrostatic pressure will
Definition
Decrease
Term
If venous resistance increases, hydrostatic pressure will
Definition
Increase
Term
How does heart failure cause peripheral edema
Definition
Increase venous pressure → increases capillary hydrostatic pressure
Term
How does nephrosis cause peripheral edema
Definition
Decreases capillary oncotic pressure → increases capillary hydrostatic pressure
Term
Flow through what, normally, balances interstitial fluid levels (preventing edema)
Definition
Lymphatic vessels
Term
Pressures in the venous system is: low or high
Definition
Low
Term
Resistance in the venous system is: low or high
Definition
Low
Term
Compliance in the venous system is: low or high
Definition
Very high
Term
On a pressure-volume graph (P as abscissa, V as ordinate), which has a more vertical slope: vein or artery
Definition
Vein since it is very compliance
Term
Increasing venous tone will do what to the right atrial pressure
Definition
Increase
Term
Decreasing the # or effectiveness of veinous valves will do what to the right atrial pressure
Definition
Decrease
Term
Increasing skeletal muscle contractions will do what to the right atrial pressure
Definition
Increase
Term
Increasing intrathoracic pressure (less negative) will do what to the right atrial pressure
Definition
Decrease
Term
Compliance = ΔV/ΔP or =ΔP/ΔV
Definition
Compliance = ΔV/ΔP [the more compliant, the more volume change per change in pressure]
Term
Which circulations have a very strong local control of blood flow (2)
Definition
1) Cerebral, 2) coronary
Term
What general mechanism does the coronary system use to control blood flow
Definition
Smooth muscle tone
Term
Challenges to local blood flow control (3)
Definition
1) Metabolic demand, 2) ischemia, 3) perfusion pressure
Term
Examples of vasodilator metabolites include (5)
Definition
1) K+, 2) adenosine, 3) prostaglandins, 4) NO, 5) H2O2
Term
Active hyperemia
Definition
Increasing blood flow through increasing metabolism
Term
Reactive hyperemia
Definition
Increasing blood flow through concentration of vascular metabolites from ischemia
Term
Exercising skeletal muscle is an example of: active hyperemia, reactive hyperemia, autoregulation
Definition
Active hyperemia
Term
Removal of a tourniquet is an example of: active hyperemia, reactive hyperemia, autoregulation
Definition
Reactive hyperemia
Term
How does the hyperemia compare between durations of ischemia where the second is a longer duration
Definition
The hyperemia of the second is larger than the first [longer ischemia → larger hyperemia]
Term
Autoregulation
Definition
Control of local blood flow despite changes in pressure [over a range of pressures]
Term
Consistent blood flow through the brain despite changes in blood pressure is an example of: active hyperemia, reactive hyperemia, autoregulation
Definition
Autoregulation
Term
Mechanisms of autoregulation (2)
Definition
1) Metabolic, 2) myogenic
Term
Under autoregulation, what metabolic change occurs to increase flow when blood pressure is decreased
Definition
Increases vasodilator metabolites ("build up") that dilates the vessels to increase flow
Term
Under autoregulation, what metabolic change occurs to decrease flow when blood pressure is increased
Definition
Decreases vasodilator metabolites ("washout") that reduces dilation of the vessels to decrease flow
Term
Under autoregulation, what myogenic change occurs to increase flow when blood pressure is decreased
Definition
Decreases smooth muscle stretch that decreases [Ca2+] and decreases contraction that causes vasoconstriction
Term
Under autoregulation, what myogenic change occurs to decrease flow when blood pressure is increased
Definition
Increases smooth muscle stretch that increases [Ca2+] and decreases contraction that causes vasodilation
Term
Which is an intrinsic property of vascular smooth muscle: metabolic or myogenic mechanism of autoregulation
Definition
Myogenic
Term
Endothelium derived relaxing factor (EDRF) aka
Definition
NO
Term
L-Arg → NO by what enzyme
Definition
NO synthase (NOS)
Term
Examples of NO stimulation (3; 2 are chemical)
Definition
1) ACh, 2) serotonin, 3) shear stress from blood flow
Term
NO ___ [inhibits or activates] platelets
Definition
Inhibits platelet activation
Term
Prostacylcin (PGI2): vasodilator or vasoconstrictor
Definition
Vasodilator [prostaglandin → PGI2 → inflammation → vasodilation → extravasation]
Term
Endothelin: vasodilator or vasoconstrictor
Definition
Vasoconstrictor [most potent known to exist]
Term
Activated platelets secrete what two things we have to care about
Definition
1) Serotonin, 2) thromboxane
Term
Serotonin: vasodilator or vasoconstrictor
Definition
Vasoconstrictor
Term
Thromboxane: vasodilator or vasoconstrictor
Definition
Vasoconstrictor
Term
Which doesn't below: NO, endothelin, serotonin, thromboxane
Definition
NO, it is a vasodilator
Term
The following are vasoconstrictors, but which indirectly causes vasodilation too: endothelin, serotonin, thromboxane
Definition
Serotonin → ↑NO → vasodilation
Term
Which has widespread vascular innervation: SNS or PSNS
Definition
SNS
Term
Which has widespread heart innervation: SNS or PSNS
Definition
Both
Term
SNS neurotransmitters (3)
Definition
1) NE, 2) NPY, 3) ATP
Term
SNS to adrenal glands secrete (2)
Definition
1) EPI, 2) NE
Term
Two subtypes of adrenergic receptors
Definition
1) α, 2) β
Term
α-adrenergics in vasculature: vasodilation or vasoconstriction
Definition
Vasoconstriction
Term
β1-adrenergics in the heart
Definition
1) ↑ chronotropy, 2) ↑ inotropy
Term
β2-adrenergics in vasculature: vaasodilation or vasoconstriction
Definition
Vasodilation
Term
Which adrenergics oppose each other in vasculature
Definition
α & β2 [REMEMBER: net effect is dependent upon concentration of receptors, α usually dominates]
Term
NE is inhibited by (2)
Definition
1) NE, 2) vasodilator metabolites
Term
Increasing SNS activity effects what changes in vascular tone (2)
Definition
1) ↑ vascular resistance, 2) ↓ vascular compliance
Term
PSNS neurotransmitter
Definition
ACh
Term
ACh's effects on the heart (3)
Definition
1) ↓ chronotropy, 2) ↓ inotropy, 3) ↓ dromotropy
Term
Humoral factors hormones (4)
Definition
1) NE, 2) EPI, 3) Ang II, 4) ADH/vasopressin
Term
Ang II: vasodilation or vasoconstriction
Definition
Vasoconstriction
Term
Ang II: increases with an ___ [increase or decrease] in arterial pressure
Definition
Decrease pressure → more Ang II
Term
Vasopressin: vasodilation or vasoconstriction
Definition
Vasoconstriction
Term
Vasopressin: increases with an ___ [increase or decrease] in arterial pressure
Definition
Decrease pressure → more vasopressin
Term
Vasopressin: increases with an ___ [increase or decrease] in blood volume
Definition
Decrease blood volume → more vasopressin
Term
Vasopressin: increases with an ___ [increase or decrease] in blood osmolarity
Definition
Increase osmolarity → more vasopressin
Term
Myocardium is perfused during: systole or diastole
Definition
Diastole
Term
Extravascular compression most affects which heart chamber
Definition
LV [most pressure]
Term
When calculating blood flow through the myocardium, the "upstream" pressure is best approximated as
Definition
Aortic diastolic pressure
Term
Pressure-rate product
Definition
Systolic arterial pressure * heart rate [name says it all no?]
Term
How do the coronary arteries "know" if the work done by the heart is increasing
Definition
Increased vasodilator metabolites
Term
Diseased coronary veesels show an increased ___ [vasoconstrictor or vasodilator] response
Definition
Vasoconstriction
Term
Vasodilator treatment may be counter-productive in patients with a coronary stenosis because of
Definition
Coronary steal
Term
Coronary steal
Definition
Vasodilation of normal coronaries may reduce flow to stenotic vessels
Term
Hypoventilation and hyperventilation are a concern for cerebral blood flow because of what substance
Definition
Carbon dioxide
Term
Hypoventilation leads to what in cerebral blood flow: vasoconstriction or vasodilation
Definition
Vasodilation
Term
Hyperventilation leads to what in cerebral blood flow: vasoconstriction or vasodilation
Definition
Vasoconstriction
Term
CNS ischemia leads to ___ [increase or decrease] in ___ [SNS or PSNS] activity that leads to ___ [vasoconstriction or vasodilation] in other tissues
Definition
Leads to increase in SNS activity leading to vasoconstriction
Term
If a capillary bed vasoconstricts, what could you postulate about CNS perfusion
Definition
Could be CNS ischemia
Term
Advantage of having extra capillaries in skeletal muscle
Definition
Under hyperemia, they become patent to increase total blood flow through an active muscle
Term
If SNS causes vasoconstriction, why would SNS activity increase during heavy exercise
Definition
Vasoconstricts in inactive skeletal muscle, leaving more blood flow for active muscles that vasodilate through metabolites
Term
Dynamic exercise has mechanisms to increase cardiac output (6)
Definition
1) SNS activity increases to arterioles, 2) SNS activity increases to veins, 3) SNS activity increases to heart, 4) PSNS activity decreases to heart, 5) skeletal muscle pump, 6) hyperventilation & the associated negative intrathoracic pressure
Term
Exercise pressor reflex
Definition
Sensory nerves in muscle cause increased SNS activity [pressor as in increases blood pressure]
Term
Splanchnic blood flow is increased post-eating how
Definition
GI hormones cause vasodilation
Term
Main function of cutaneous blood flow regulation
Definition
Temperature regulation
Term
Arteriovenous anastamoses of the skin are under what control
Definition
SNS
Term
Arteriovenous anastamoses of the skin are NOT under what control (3)
Definition
1) Local regulation, 2) autoregulation, 3) reactive hyperemia
Term
Local cooling of the skin induces: vasoconstriction or vasodilation
Definition
Vasoconstriction
Term
Baroreceptors
Definition
Sense changes in blood pressure
Term
Tonic baroreceptors ___ [inhibit or activate] SNS and ___ PSNS
Definition
Inhibit SNS and activate PSNS
Term
Carotid sinus innervated by which CN
Definition
CN IX
Term
Arotic arch innervated by which CN
Definition
CN X
Term
Carotid sinus & aortic arch afferents to which nucleus
Definition
Nucleus tractus solitarius (NTS)
Term
How do baroreceptors detect blood pressure
Definition
Distension of vessel wall stretches/relaxes nerves and they change depolarization frequency
Term
Increased baroreceptor frequency indicates ___ [increase or decrease] in blood pressure
Definition
Increase in blood pressure
Term
How could aging affect baroreceptor function
Definition
Decreased vessel compliance with age → decreased baroreceptor function
Term
Minimum pressure for baroreceptor firing
Definition
40-60 mmHg
Term
Saturation pressure for baroreceptor firing
Definition
180 mmHg
Term
Increased baroreceptor firing __ [increases or decreases] vasopressin
Definition
Decreases vasopressin
Term
What is baroreceptor adaptation/resetting [I don't get the difference]
Definition
Shift in pressure sensitivity from sustained blood pressure change
Term
What is the long-term consequence of the fast baroreceptor adaptation/resetting
Definition
Chronic blood pressure adjustment must be done by means other than the baroreceptor reflex
Term
How long does baroreceptor adaptation/resetting take
Definition
Minutes
Term
Under chronic hypertension, baroreceptor sensitivity: increases or decreases
Definition
Decreases
Term
Consequences of decrease baroreceptor sensitivity (5)
Definition
1) Increased blood pressure variability, 2) arrhythmias, 3) sudden cardiac death post-MI/HF/DM, 4) high SNS activity, 5) low PSNS activity
Term
Which plot [top or bottom] is more likely from decreased baroreceptor sensitivity
Definition
Bottom
Term
What sensors exist in the heart (2)
Definition
1) Mechanosenstivie, 2) chemosensitive
Term
When are mechanosensitive cardiac vagal afferents active in healthy people
Definition
Normally active, particularly when laying down
Term
Chemical factors that activate vagal & SNS afferents on MI, thrmobosis, & reperfusion (6)
Definition
1) Prostaglandins, 2) adenosine, 3) bradykinin, 4) serotonin, 5) reactive oxygen species, 6) H+
Term
Increased cardiac vagal afferents ___ [increases or decreases] SNS activity
Definition
Decreases
Term
Increased cardiac vagal afferents ___ [increases or decreases] vasopressin release
Definition
Decreases
Term
Decreased activity from cardiac vagal afferents results in (5)
Definition
1) Decreases TPVR, 2) increased renal blood flow, 3) decreases renin, 4) increased urine, 5) increased sodium excretion
Term
Increased cardiac vagal afferents works to ___ [increase or decrease] total blood volume
Definition
Decrease
Term
Increased activity from arterial baroreceptors results in (6)
Definition
1) Decreases TPVR, 2) decreases heart rate, 3) increased renal blood flow, 4) decreases renin, 5) increased urine, 6) increased sodium excretion
Term
Cardiac vagal afferents then affects: SNS or PSNS activity
Definition
SNS activity
Term
Arterial baroreceptors then affects: SNS or PSNS activity
Definition
Both SNS & PSNS
Term
Effects of mild hemorrhage (3)
Definition
1) Increased SNS activity, 2) vasoconstriction, 3) increased heart rate
Term
Effects of severe hemorrhage (4)
Definition
1) Increased PSNS activity, 2) decreases SNS activity, 3) decreased TPVR, 4) decreased heart rate
Term
Why are the effects of severe hemorrhage "paradoxical"
Definition
They are in the opposite direction of the actions needed to curb severe hemorrhage
Term
Bezold Jarisch reflex
Definition
Neurocardiogenic syncope from certain drugs that evoke a paradoxical activation of cardiac vagal afferents
Term
Carotid body contains what kind of cells
Definition
Glomus cells
Term
What depolarizes glomus cells (3)
Definition
1) Hypoxia, 2) hypercapnia, 3) acidosis
Term
Increased carotid body activity leads to what responses (4)
Definition
1) Increased ventilation, 2) increased SNS activity to vasculature, 3) increased PSNS activity to heart, 4)
Term
What response of the carotid body opposes/inhibits the activity of the carotid body
Definition
Increased ventilation
Term
Lung inflation reflex ___ [activates or inhibits] ___ [SNS or PSNS] activity to the heart
Definition
Inhibits PSNS activity [make sense? PSNS activity is significantly faster than SNS activity]
Term
Respiratory sinus arrythmia: physiological or pathological
Definition
Physiological
Term
Lung inflation reflex ___ [activates or inhibits] ___ [SNS or PSNS] activity to the vasculature
Definition
Inhibits SNS activity
Term
Ergoreceptors
Definition
Exercise-induced SNS activation by skeletal muscle
Term
Diving reflex effects
Definition
1) Apnea, 2) increase PSNS to heart, 3) increase SNS to vasculature
Term
Trigeminal afferent reflex aka
Definition
Diving reflex
Term
Damage from blood pressure variability (4)
Definition
1) Cardiac & vascular hypertrophy, 2) kidney damage, 3) retinopathy, 4) stroke
Term
Which is physiological: blood pressure variability or heart rate variability
Definition
Heart rate variability
Term
Which is pathological: blood pressure variability or heart rate variability
Definition
Blood pressure variability
Term
Respiratory sinus arrhythmia: low- or high-frequency
Definition
High frequency
Term
Long-term control of arterial pressure (4)
Definition
1) Renal, 2) vascular hypertrophy, 3) neurohormonal (NE, Ang II, endothelin, NO, ROS), 4) environment (dietary salt, stress)
Term
For a given LVEDP, increasing contractility will ___ [increase or decrease] stroke volume
Definition
Increase
Term
For a given LVEDP, increasing afterload will ___ [increase or decrease] stroke volume
Definition
Decrease
Term
Increasing cardiac output will ___ [increase or decrease] right atrial pressure
Definition
Decrease
Term
Cardiac output and right atrial pressure are: proportional or inversely proportional
Definition
Inversely proportional
Term
This curve is called what
Definition
Cardiac function curve
Term
This curve is called what
Definition
Vascular function curve
Term
For a given right atrial pressure, increasing blood volume will ___ [increase or decrease] cardiac output
Definition
Increase
Term
For a given right atrial pressure, increasing venous compliance will ___ [increase or decrease] cardiac output
Definition
Decrease
Term
Vascular function curve: changing blood volume: shifts curve or changes slope of the curve
Definition
Shifts curve
Term
Vascular function curve: changing venous compliance: shifts curve or changes slope of the curve
Definition
Shifts curve
Term
Vascular function curve: changing TPVR: shifts curve or changes slope of the curve
Definition
Changes slope
Term
Why does changing TPVR have no effect on right atrial pressure when cardiac output is zero
Definition
Peripheral resistance is irrelevant to filling pressure when there is no flow
Term
Renin-angiotensin-aldosterone system
Definition
Controls sodium & water levels in the blood
Term
Ang I → Ang II by what enzyme
Definition
ACE
Term
Ang II → Ang(1-7) by what enzyme
Definition
ACE2
Term
Main receptor for Ang I
Definition
AT1R
Term
Does RAAS ___ [oppose or synergize] with atrial natriuretic peptide
Definition
Oppose
Term
Circulatory shock
Definition
Inadequate tissue perfusion
Term
Classifications of shock (4)
Definition
1) Hypovolemic, 2) cardiogenic, 3) hypermetabolic, 4) neurogenic
Term
What classification of shock: hemorrhage
Definition
Hypovolemic
Term
What classification of shock: post-myocardial infarction
Definition
Cardiogenic
Term
What classification of shock: valve dysfunction
Definition
Cardiogenic
Term
What classification of shock: arrhythmias
Definition
Cardiogenic
Term
What classification of shock: sepsis
Definition
Hypermetabolic
Term
What classification of shock: infection
Definition
Hypermetabolic
Term
What classification of shock: spinal cord injury
Definition
Neurogenic
Term
What classification of shock: excess epidural anesthesia
Definition
Neurogenic
Term
Significant events of hemorrhage (5)
Definition
1) ↓ central volume, 2) ↓ LVEDV/P, 3) ↓ SV, 4) ↓ CO 5) ↓ MAP
Term
Shift from A to B might happen from
Definition
Hemorrhage
Term
Shift from A to B might happen from
Definition
Hemorrhage
Term
What triggers an increase in SNS activity (2)
Definition
1) Decreased baroreceptor activity, 2) decreased cardiopulmonary vagal afferents activity
Term
What triggers an increase in vasopressin (2)
Definition
1) Decreased baroreceptor activity, 2) decreased cardiopulmonary vagal afferents activity
Term
What triggers a decrease in PSNS activity (2)
Definition
1) Decreased baroreceptor activity, 2) decreased cardiopulmonary vagal afferents activity
Term
What triggers a decrease in baroreceptor activity (2)
Definition
1) Decreased arterial pressure, 2) decreased arterial pulse pressure
Term
What triggers a decrease in cardiopulmonary vagal afferents
Definition
Decreased central blood volume
Term
What triggers an increase in renal Na and H2O reabsorption (5)
Definition
1) Increased vasopressin, 2) increased SNS activity, 3) increased aldosterone, 4) increased renin, 5) increased Ang II
Term
What causes an increase in heart rate (2)
Definition
1) Increased SNS activity, 2) decrased PSNS activity
Term
What causes an increase in TPVR (4)
Definition
1) Increased renin, 2) increased Ang II, 3) increased SNS activity, 4) increased vasopressin
Term
What causes an increase in cardiac output (2)
Definition
1) Increased heart rate, 2) increased stroke volume
Term
What causes an increase in stroke volume (2)
Definition
1) Increased contractility, 2) increased right arterial pressure & increased LVEDP
Term
What causes an increase in right atrial pressure (2)
Definition
1) Increased blood volume, 2) decreased venous compliance
Term
What causes an increase in blood pressure (2)
Definition
1) Increased TPVR, 2) increased cardiac output
Term
What causes an increase in blood volume (2)
Definition
1) Fluid reabsorption into capillaries, 2) renal Na & H2O reabsorption
Term
What releases renin
Definition
Juxtaglomerular cells in kidneys
Term
Shift from B to C might happen from
Definition
Increased inotropy → increased SV → increased CO
Term
Shift from B to C might happen from
Definition
Increased inotropy → increased SV → increased CO
Term
Shift from B to C might happen from
Definition
Decreased venous compliance or increased blood volume
Term
Shift from B to C might happen from
Definition
Decreased venous compliance or increased blood volume
Term
Increasing contractility will ___ [increase or decrease] preload
Definition
Decrease, but not by much
Term
Shift from B to C might happen from
Definition
Increased TPVR
Term
Shift from B to C might happen from
Definition
Increased TPVR
Term
Treatments of hypovolemic shock (4)
Definition
1) Stop bleeding, 2) fluid resuscitation, 3) vasoconstrictors, 4) others (e.g., acid/base, temperature)
Term
Heart failure
Definition
Reduced ejection fraction
Term
Causes of heart failure (6)
Definition
1) MI, 2) chronic hypertension, 3) valvular heart disease, 4) pulmonary hypertension, 5) AV shunts, 6) cardiomyopathy
Term
Shift might happen from
Definition
Loss of contractility from an MI
Term
Shift might happen from
Definition
Loss of contractility from an MI
Term
Shift from grey to teal might happen from
Definition
Increased SNS to heart post-MI
Term
Shift from grey to teal might happen from
Definition
Increased SNS to heart post-MI
Term
Shift to purple might happen from
Definition
Increased SNS to arterioles [grey line is SNS to heart only]
Term
Shift to purple might happen from
Definition
Increased SNS to arterioles [grey line is SNS to heart only]
Term
Shift to teal might happen from
Definition
Increased SNS to decrease venous compliance [previous was SNS to heart & arterioles]
Term
Shift to teal might happen from
Definition
Increased SNS to decrease venous compliance [previous was SNS to heart & arterioles]
Term
Spiral downward happens when heart failure becomes ___ due to ___
Definition
Congested heart failure due to increasing SNS activity
Term
Ways to reverse congestion in heart failure is be giving (2)
Definition
1) Vasodilators, 2) diuretics
Term
Cardiac & vascular function curves are not good at discriminating (2)
Definition
1) Afterload, 2) stroke volume
Term
Primary ciliary dyskinesia
Definition
Immotile cilia → respiratory tract problems
Term
Brush cells
Definition
Sensory cells; unidentifiable in histo preps
Term
Granule cells
Definition
Neuroendocrine network; unidentifiable in histo preps
Term
Which part of the respiratory mucosa is highly vascularized
Definition
Lamina propria
Term
Swell bodies function
Definition
Prevents dessication
Term
Cell types in olfactory epithelium (3)
Definition
1) Basal, 2) sustentacular, 3) olfactory neurons
Term
Cell morphology of olfactory neurons
Definition
Bipolar
Term
Glands in the lamina propria of olfactory mucosa
Definition
Glands of Bowman
Term
Where in the epithelium of the respiratory tract does endoderm meet ectoderm
Definition
Nasopharynx
Term
Progression of epithelia in bronchioles
Definition
pseudostratified columnar → simple cuboidal
Term
Clara cells
Definition
Produce GAG's to protect against airborne toxins
Term
Types of bronchioles (3)
Definition
1) Regular, 2) terminal, 3) respiratory
Term
Last bronchiole type in the conducting zone
Definition
Terminal bronchioles
Term
Structures of the blood-air barrier (3)
Definition
1) Squamous alveolar cell, 2) basal lamina, 3) capillary endothelial cell
Term
What secretes surfactant
Definition
Type II pneumocytes
Term
Respiratory distress syndrome
Definition
Neonates without developed type II pneumocytes
Term
Macrophages in lung tissue aka
Definition
Dust cells
Term
Epithelia type in alveoli
Definition
Simple squamous
Term
Where in the pulmonary tree do goblet cells diminish in number
Definition
Terminal bronchioles
Term
Where in the pulmonary tree to alveoli appear
Definition
Respiratory bronchioles
Term
PaO2
Definition
Partial pressure of oxygen in arterial blood
Term
PAO2
Definition
Partial pressure of oxygen in alveolar gas
Term
SaO2
Definition
Saturation of oxygen in arterial blood
Term
PaCO2
Definition
Partial pressure of carbon dioxygen in arterial blood
Term
PACO2
Definition
Partial pressure of carbon dioxygen in alveolar gas
Term
PO2
Definition
Partial pressure of oxygen in blood
Term
PALV
Definition
Alveolar pressure
Term
PPL
Definition
Pleural pressure
Term
PAO
Definition
Pressure at the airway opening
Term
PATM
Definition
Atmospheric pressure
Term
PPA
Definition
Hydrostatic pressure in the pulmonary arteries
Term
PPV
Definition
Hydrostatic pressure in the pulmonary veins
Term
PFT
Definition
Pulmonary function test
Term
TLC
Definition
Total lung capacity
Term
VE
Definition
Minute ventilation (=breaths per minute * voluem per breath)
Term
VT
Definition
Tidal volume
Term
VA
Definition
Alveolar ventilation
Term
VD
Definition
Dead space ventilation
Term
Main factor controller drive
Definition
PaCO2
Term
Level in which PaCo2 is regulated
Definition
40 mmHg
Term
Location in the body with lowest PO2
Definition
Mitochondria
Term
Location in the body with highest PCO2
Definition
Mitochondria
Term
Respiratory drive originates in the
Definition
Medulla
Term
Normally, inspiration is caused by a pressure drop in ___ that drops the pressure in the ___
Definition
Drop in the pleural pressure that drops the alveolar pressure
Term
Normal respiration is an example of ___ [negative or positive] pressure respiration
Definition
Negative
Term
Mechanical ventilation is an example of ___ [negative or positive] pressure respiration
Definition
Positive
Term
Most important mechanical properties of respiration (2)
Definition
1) Resistance, 2) compliance
Term
Resistance =
Definition
R = ΔP / flow
Term
Asthma affects: resistance or compliance
Definition
Resistance
Term
Pulmonary fibrosis affects: resistance or compliance
Definition
Compliance
Term
Obesity affects: resistance or compliance
Definition
Compliance
Term
Compliance =
Definition
C = ΔV / ΔP
Term
Emphysema affects: resistance or compliance
Definition
Compliance
Term
Dominant form in which CO2 is transported
Definition
Bicarbonate
Term
Dominant form in which O2 is transported
Definition
On hemoglobin [= oxyhemoglobin]
Term
Name that PFT: maximum lung volume
Definition
TLC
Term
Name that PFT: minimum lung volume
Definition
RV
Term
Name that PFT: maximum expiration to maximum inspiration
Definition
VC
Term
Name that PFT: volume of resting breathing
Definition
TV
Term
Name that PFT: resting expiration to maximum inspiration
Definition
IC
Term
Name that PFT: resting expiration to maximum expiration
Definition
ERV
Term
Name that PFT: total volume at resting expiration
Definition
FRC
Term
IRV
Definition
Inspiration reserve volume
Term
ERV
Definition
Expiration reserve volume
Term
TV
Definition
Tidal volume
Term
FRC
Definition
Functional residual capacity
Term
RV
Definition
Residual volume
Term
IC
Definition
Inspiratory capacity
Term
VC
Definition
Vital capacity
Term
Volume in which lung recoil matches chest wall expansion
Definition
FRC
Term
Increase or decrease in FRC: obesity
Definition
Decrease
Term
Increase or decrease in FRC: fibrosis
Definition
Decrease
Term
Increase or decrease in FRC: diffusely scarred lungs
Definition
Decrease
Term
Increase or decrease in FRC: emphysema
Definition
Increase
Term
FEV1
Definition
Forced expiratory manuever in 1 second
Term
Increase or decrease in FEV1: asthma
Definition
Decrease
Term
Secondary tasks of the respiratory system (4)
Definition
1) Control pH, 2) heat exchange, 3) immune surveillance, 4) chemistry lab of sorts (e.g., ACE)
Term
Respiratory system =
Definition
Lungs & chest wall
Term
Unencumbered, lungs would collapse on their own to __% of TLC
Definition
10%
Term
Surfactant __ [increases or decreases] surface tension
Definition
Decreases surface tension
Term
Pleural pressure is normally about
Definition
-5 cmH2O
Term
Primary muscle of inspiration
Definition
Diaphragm
Term
Secondary muscles of inspiration
Definition
1) Scalenes, 2) SCM, 3) back & neck muscles, 4) upper airway dilator muscles
Term
Secondary muscles of expiration
Definition
1) Internal intercostals, 2) abdominal muscles
Term
Which curve is emphysema: top or bottom curve
Definition
Top
Term
Increase or decrease in FRC: pulmonary edema
Definition
Decrease
Term
Increase or decrease in compliance: kyphoscoliosis
Definition
Decrease
Term
Which curve is fibrosis: top or bottom curve
Definition
Bottom
Term
Does lung deflation & inflation follow the same path on a P-V plot?
Definition
No, lungs have hysteresis
Term
Why is the plot so flat at the red arrow
Definition
Collapsed alveoli are not compliant
Term
Name for the bend at the purple arrow
Definition
Inflection point
Term
What kind of breathing happens at the green arrow
Definition
Tidal breathing
Term
Transpulmonary pressure is highest at: base or apex of lungs
Definition
Apex
Term
Resistance is greatest in which part of the airway
Definition
Trachea
Term
Air velocity is greatest in which part of the airway
Definition
Trachea
Term
Maximal expiratory flow is largely ___ [dependent or independent] of effort
Definition
Independent
Term
Bernoulli effect matters on maximal expiration in what way
Definition
Velocity decreases pressure which collapses the airway thus increasing resistance
Term
What counters the Bernoulli effect in larger airways
Definition
Cartilage
Term
Reasons why emphysema reduces FEV1 (2)
Definition
1) Reduced elastic recoil, 2) floopier airways that collapse during expiration
Term
Tricky question: do lungs passively or actively expand during inspiration
Definition
Passive: the chest wall activately expands and the lungs passively inflate
Term
__% of oxygen consumption is used to breathe at rest
Definition
<5%
Term
Work of breathing =
Definition
W = ΔP * ΔV
Term
Equation of Moation for the lung: ΔP =
Definition
ΔP = R*flow + ΔV/Crs
Term
Atmosphere is __% N2, __% O2
Definition
79% N2, 21% O2
Term
PO2 is usually
Definition
PO2 = 760 mmHg * 21% = 160 mmHg
Term
PH2O in lungs =
Definition
47 mmHg
Term
Forms of CO2 in the body (3)
Definition
1) Dissolved CO2, 2) bicarbonate, 3) carbamino
Term
Dissolved CO2 in plasma is about __% of total CO2
Definition
5%
Term
CO2 ↔ bicarbonate by what enzyme
Definition
Carbonic anhydrase
Term
As bicarbonate leaves an RBC, what enters to maintain eleconeutrality and produces a "__"
Definition
Chloride produces a "chloride shift"
Term
Minute ventilation =
Definition
VE = tidal volume * respiratory rate
Term
Portion of minute ventilation that does not participate in gas exchange
Definition
Dead space ventilation (VD)
Term
Is dead space ventilation __ [anatomical or physiological] dead space
Definition
Anatomical
Term
Portion of minute ventilation that does participate in gas exchange
Definition
Alveolar ventilation (VA)
Term
VA + VD =
Definition
VT
Term
PCO2 is __ [directly or inversely] proportional to VCO2
Definition
Directly proportinonal
Term
PCO2 is __ [directly or inversely] proportional to VA
Definition
Inversely proportional
Term
A gas that is dependent upon blood flow is said to be: diffusion-limited or perfusion-limited
Definition
Perfusion-limited [more flow will transfer more gas]
Term
A gas that is independent upon blood flow is said to be: diffusion-limited or perfusion-limited
Definition
Diffusion-limited [more flow won't transfer more gas]
Term
Is respiration in humans at rest ___ [diffusion or perfussion] limited
Definition
In between them
Term
When might human respiration be diffusion-limited
Definition
Mt. Everest
Term
What best explains hypoxemia in patients with really thick alveolar walls
Definition
NOT DIFFUSION-LIMITED! No, instead think ventilation-perfusion mismatch
Term
1 gram of Hb carries __ mL of O2 and 1 dL of blood has normally __ grams of Hb
Definition
1 g Hb = 1.34 mL O2; body has 15 grams [not likely to have to know this, but you will have to know Hb/dL some day]
Term
Relationship between PO2 and SO2
Definition
Sigmoidal
Term
Relationship between PCO2 and SCO2
Definition
Linear
Term
Left shifting of the Hb-dissociation curve is __ [increased or decreased] oxygen affinity
Definition
Increased
Term
Right shifting of the Hb-dissociation curve is __ [increased or decreased] oxygen affinity
Definition
Decreased
Term
Hemoglobin-dissociation curve: increased pH __ [increases or decreases] O2 affinity
Definition
Increases
Term
Hemoglobin-dissociation curve: decreased pH __ [increases or decreases] O2 affinity
Definition
Decreases
Term
Hemoglobin-dissociation curve: increased temperature __ [increases or decreases] O2 affinity
Definition
Decreases
Term
Hemoglobin-dissociation curve: decreased temperature __ [increases or decreases] O2 affinity
Definition
Increases
Term
Hemoglobin-dissociation curve: increased 2,3-DPG __ [increases or decreases] O2 affinity
Definition
Decreases
Term
Hemoglobin-dissociation curve: decreased 2,3-DPG __ [increases or decreases] O2 affinity
Definition
Increases
Term
Is the myoglobin-dissociation curve to the "left" or "right" of the Hb-dissociation curve
Definition
Left
Term
Which is worse, when ventilation exceeds perfusion or when perfusion exceeds ventilation
Definition
When perfusion exceeds ventilation
Term
FIO2
Definition
Fraction of inspired air that is oxygen (% oxygen = 21%)
Term
PAO2 =
Definition
PAO2 = PaO2 - PCO2/R = FIO2*(Patm-PH2O) - PCO2/R
Term
Respiratory exchange ratio [i.e., respiratory quotient] =
Definition
R = RQ = VCO2/VO2
Term
Ideal PAO2 in Iowa City = __ mmHg
Definition
98 mmHg or about 100 mmHg
Term
What is the upper bound to PAO2
Definition
Infinite ventilation and no perfusion (PAO2=0 mmHg)
Term
What is the lower bound to PAO2
Definition
Zero ventilation (PAO2=40 mmHg matches venous blood)
Term
A-a gradient is a clinically useful measure of
Definition
Lung dysfunction
Term
Ideal lungs have an A-a gradient of
Definition
Zero
Term
West zones of the lungs (3; inferior to superior)
Definition
3, 2, 1
Term
PA > Pa > Pv describes which West zone
Definition
1
Term
Pa > PA > Pv describes which West zone
Definition
2
Term
Pa > Pv > PA describes which West zone
Definition
3
Term
Which pressure changes its order between the West zones
Definition
PA
Term
Why is there no blood flow in the West zone 1
Definition
Alveolar pressure closes arterial and venous vessels
Term
Why is there some blood flow in the West zone 2
Definition
Arterial pressure exceeds alveolar pressure
Term
Why is there good blood flow in the West zone 3
Definition
Arterial and venous pressure are greater than alveolar
Term
Blood flow in West zone 1 is
Definition
Zero
Term
Blood flow in West zone 2 is determined by what pressure gradient
Definition
PA - Pa
Term
Blood flow in West zone 3 is determined by what pressure gradient
Definition
PA - Pv
Term
Why are the alveoli at the apex of the lung less compliant
Definition
They are more distended due to higher transmural pressure, higher volume means less compliant
Term
Which West zone ventilates and perfuses better
Definition
3
Term
Can you average PCO2 levels when mixing two volumes of blood: yes or no
Definition
Yes
Term
Can you average PO2 levels when mixing two volumes of blood: yes or no
Definition
No [I guarantee this is a test question some how. GUARANTEE!]
Term
What is the root problem with V/Q mismatch
Definition
Low V/Q units contributing hypoxemic blood thus preventing adequate oxygen levels leaving lungs
Term
Why is SO2 not 100% in healthy resting individuals
Definition
Half of bronchial circulation returns via pulmonary veins
Term
If bronchi do not participate in gas exchange and have no pulmonary circulation, how are they perfused
Definition
Bronchial circulation, which is apart of the systemic circulation
Term
SO2 not being 100% in healthy resting individuals is due to a __ [anatomical or physiological] shunt
Definition
Physiological shunt
Term
How does the pulmonary circulation retain high compliance under high cardiac output (e.g., exercising)
Definition
Pulmonary arterial pressure increases and shifts the West zones more apically so that more of the lungs are in zones 2 & 3
Term
What mechanism permits V/Q matching in healthy individuals by not perfusing unventilated alveoli
Definition
Hypoxic pulmonary vasoconstriction [arterioles constrict under hypoxia, unlike systemic arterioles that would dilate]
Term
Is the ventilation-perfusion shown healthy: yes or no
Definition
Yes, some V/Q mismatch always occurs
Term
What is "shunt"
Definition
Blood flow from right to left heart that never sees alveolar gas
Term
Which responds well to oxygen therapy: V/Q mismatch or shunt
Definition
V/Q mismatch
Term
Should oxygen therapy be given for shunt
Definition
Yes, the difference in SO2 may be small but it may be clinically significant
Term
V/Q mismatch is often a problem of the
Definition
Airways
Term
Shunt is often a problem of the
Definition
Alveolar filling or collapsing
Term
Which is most likely to show up on a chest x-ray: V/Q mismatch or shunt
Definition
Shunt
Term
Ways that V/Q mismatch differs clinically from shuns (3)
Definition
1) Causitive lesions occurs in different locations, 2) chest x-rays differ, 3) different response to oxygen therapy
Term
At maximum exercise: heart rate can increase by what factor
Definition
~3-4 [70 to 200 bpm]
Term
At maximum exercise: cardiac output can increase by what factor
Definition
~7-8 [5 to 35-40 L/min]
Term
At maximum exercise: sweat production rate
Definition
1-2 L/hr
Term
At maximum exercise: ventilation can increase by what factor
Definition
~20-30 [5 to 120-160 L/min]
Term
Shunting of blood to the skin to dissipate heat can cause what change to heart function
Definition
Decreases preload
Term
Sweat production can cause what change to heart function
Definition
Decreases blood volume and, thusly, preload
Term
Until reaching VO2 max, what is the relationship between oxygen uptake and workload
Definition
Linear
Term
VO2 max =
Definition
VO2 max = cardiac output * maximum a-v O2 difference
Term
Training has what oxygen handling effects on muscle (2)
Definition
1) Increased myoglobin, 2) increased capillarization
Term
How quickly can bed rest reduce VO2 max
Definition
Weeks: about 3
Term
Who has the largest drop in VO2 max after bed rest: trained or untrained people
Definition
Trained lose the most in VO2 max
Term
Training __ [increases or decreases] SV in the young
Definition
Increases
Term
Training __ [increases or decreases] SV in the older
Definition
Increases
Term
Training __ [increases or decreases] maximal a-v difference in the youngTraining __ [increases or decreases] maximal a-v difference in the young
Definition
Increases
Term
Training __ [increases or decreases] maximal a-v difference in the older
Definition
No change
Term
What does VO2 max decrease with age (2)
Definition
1) Loss of muscle mass, 2) decrease in maximal heart rate
Term
Why is VO2 max different between the sexes
Definition
Lower hemoglobin concentration
Term
Energy sources of skeletal muscle (3)
Definition
1) Phosphocreatine, 2) glycogen/glucose, 3) triglycerides
Term
At maximum exercise: ATP supply in a muscle would last about how long
Definition
1 second
Term
At maximum exercise: phosphocreatine supply in a muscle would last about how long
Definition
10 seconds
Term
At maximum exercise: aerobic oxidation supply in a muscle would last about how long
Definition
A really long time as long as fatty acids are used
Term
At maximum exercise: anaerobic glycolysis in a muscle would last about how long
Definition
1-5 minutes
Term
RER =
Definition
RER = VCO2/VO2
Term
RQ =
Definition
RQ = VCO2/VO2
Term
Which measures systemic O2 → CO2: RER or RQ
Definition
RER
Term
Which measures cellular O2 → CO2: RER or RQ
Definition
RQ
Term
RER for carbohydrates =
Definition
1
Term
RER for fatty acids =
Definition
0.7
Term
Which curve represents fat: the one with positive or negative slope
Definition
Negative slope [fat usage as substrate decreases with intensity]
Term
Factors that affect substrate utilization during exercise (2)
Definition
1) Work intensity, 2) state of physical training
Term
State of physical training has effects that affect substrate utilization (2)
Definition
1) Increased ability to mobilze & utilize fats, 2) glycogen is spared as a consequence of (1)
Term
In an untrained person, lactate threshold is about __% of VO2 max
Definition
50-60% of VO2 max
Term
In a trained person, lactate threshold is about __% of VO2 max
Definition
80-90% of VO2 max
Term
Which skeletal muscle fibers are innervated by large motor neurons: type I or II
Definition
Type II
Term
Which skeletal muscle fibers are innervated by small motor neurons: type I or II
Definition
Type I
Term
Which skeletal muscle fibers are recruited first: type I or II
Definition
Type I
Term
Which skeletal muscle fibers are recruited last: type I or II
Definition
Type II
Term
Fiber types based on metabolism (3)
Definition
1) Slow oxidative, 2) Fasto oxidative glycolytic, 3) fast glycolytic
Term
Henneman size principle
Definition
Muscle fibers recruited from smallest to largest size
Term
Which skeletal muscle fibers are recruited for high velocity: type I or II
Definition
Type II
Term
Fiber diameter: SO < FOG < FG or SO > FOG > FG
Definition
SO < FOG < FG
Term
Mitochondrial density: SO < FOG < FG or SO > FOG > FG
Definition
SO > FOG > FG
Term
Capillary density: SO < FOG < FG or SO > FOG > FG
Definition
SO > FOG > FG
Term
Myoglobin content: SO < FOG < FG or SO > FOG > FG
Definition
SO > FOG > FG
Term
Twitch time: SO < FOG < FG or SO > FOG > FG
Definition
SO < FOG < FG
Term
Force production: SO < FOG < FG or SO > FOG > FG
Definition
SO < FOG < FG
Term
Fatigability: SO < FOG < FG or SO > FOG > FG
Definition
SO < FOG < FG
Term
Triglyceride stores: SO < FOG < FG or SO > FOG > FG
Definition
SO > FOG > FG
Term
Oxidative enzyme activity: SO < FOG < FG or SO > FOG > FG
Definition
SO > FOG > FG
Term
Training of muscle: hypertrophy or hyperplasia
Definition
Hypertrophy
Term
Does aerobic training increase lactate buffering: yes or no
Definition
No
Term
Does anaerobic training increase lactate buffering: yes or no
Definition
Yes
Term
Delayed onset muscle soreness (6)
Definition
1) Cellular damage, 2) inflammation, 3) PGE2 sensitization of nerve endings, 4) histamine, 5) edema, 6) hyperthermia [more, but these are big ones IMHO]
Term
Is the CPG __ [unilateral or bilateral]
Definition
Bilateral
Term
Do upper dilators matter: yes or no
Definition
Yes [and it's frequently underappreciated]
Term
What may contribute to sleep apnea
Definition
Reduced activity of upper airway dilators
Term
Neuron groups involved in respiration (2)
Definition
1) DRG, 2) VRG
Term
DRG receives afferents from (2)
Definition
1) CN IX, 2) CN X
Term
Which contains motor neurons: DRG or VRG
Definition
VRG
Term
Which controls inspiration: DRG or VRG
Definition
Both
Term
Which controls expiration: DRG or VRG
Definition
VRG
Term
Does the VRG receive afferents directly or indirectly
Definition
Indirectly from the DRG
Term
Hypothesized location of the CPG
Definition
Pre-Botzinger complex [rostral VRG]
Term
Groups of respiratory neurons in the pons that modulate respiratory activity (2)
Definition
1) Apneustic center, 2) pneumotaxic center
Term
Peripheral chemoreceptors (2)
Definition
1) Carotid body, 2) aortic body
Term
Peripheral chemoreceptors primarily respond to
Definition
Hypoxia
Term
Why are peripheral chemoreceptors innervated by SNS & PSNS if they have chemoreceptors
Definition
Autonomics module blood supply to modulate flow to the chemoreceptors
Term
If SNS activity to the carotid body is increased, what do the chemoreceptors tell the CPG to do
Definition
Increase ventilation [because the carotid body is sensing hypoxia from vasoconstriction]
Term
Glomus cells [type I cells]
Definition
Actual chemosensitive cells
Term
Actual chemosensitive cells of the carotid body
Definition
Glomus cells
Term
What cells support glomus cells
Definition
Sustentacular cells
Term
Sustentacular cells [type II cells]
Definition
Support glomus cells [sustentacular is Latin "to support" so think sustain]
Term
Chemoreceptors sense changes to CO2, O2, pH and converge on inhibition of
Definition
Inhibition of potassium channels
Term
Chemoreceptors fire when potassium channels are: inhibited or activated
Definition
Inhibited [leads to depolarization and calcium influx]
Term
Inhibition of potassium channels in chemoreceptors caused by __ [increase or decrease] in PCO2
Definition
Increase PCO2
Term
Inhibition of potassium channels in chemoreceptors caused by __ [increase or decrease] in PO2
Definition
Decrease PO2
Term
Inhibition of potassium channels in chemoreceptors caused by __ [increase or decrease] in pH
Definition
Decrease pH
Term
Central chemoreceptors
Definition
Found in medulla
Term
Why are central chemoreceptors slow to respond to pH changes
Definition
Blood-brain barrier is relativiely insensitive to strong ions like H+
Term
Some neurons exist that mediate arousal to CO2, what kind and where
Definition
Serotonergic neurons in the midbrain
Term
Which neurons may play a role in SIDS
Definition
Midbrain neurons that mediate arousal to CO2
Term
__% to __% of ventilatory response to CO2 is accounted for by the central chemoreceptors
Definition
80-90%
Term
For a given PCO2, does increasing PO2 __ [increase or decrease] ventilation rate
Definition
Decreases ventilation rate
Term
For a given PCO2, does decreasing PO2 __ [increase or decrease] ventilation rate
Definition
Increases ventilation rate
Term
For a given PO2, does increasing PCO2 __ [increase or decrease] ventilation rate
Definition
Increases ventilation rate
Term
For a given PO2, does decreasing PCO2 __ [increase or decrease] ventilation rate
Definition
Decreases ventilation rate
Term
Sensory receptors in the lung & upper airways (3)
Definition
1-2) Slowly & rapidly adapting pulmonary stretch, 3) C-fiber receptors
Term
Slowly adapting pulmonary stretch receptors ___ [increase or decrease] firing with decreased lung volume
Definition
Decrease firing with decreased lung volume
Term
Activation off slowly adapting pulmonary stretch receptors __ [inhibits or activates] ventilation
Definition
Inhibits
Term
Rapidly adapting pulmonary stretch receptors detect
Definition
Chemicals: histamine, prostaglandins, cigarette smoke
Term
C-fiber receptors respond to what modalities (2)
Definition
1) Chemical, 2) mechanical
Term
Activation of C-fiber receptors leads to (3)
Definition
Prevent penetration of foreign materials: 1) Bronchoconstriction, 2) increased mucus, 3) rapid, shallow breathing
Term
Reticular activating system
Definition
Source of tonic drive to breathe during wakefulness
Term
Sudden shock leads to what breathing pattern
Definition
Sudden, sharp inspiration
Term
Does PCO2 tend to ___ [rise or fall] a few mmHg during sleep
Definition
Fall a few mmHg [and this is done by the reticular activating system]
Term
Central sleep apnea
Definition
Abnormally reduced central drive during sleep
Term
Obstructive sleep apnea
Definition
Upper airway dilator activity declines leading to inspiratory narrowing
Term
Which still retains respiratory effort during zero airflow: central or obstructive sleep apnea
Definition
Obstructive sleep apnea
Term
Which has no respiratory effort during zero airflow: central or obstructive sleep apnea
Definition
Central sleep apnea
Term
How does the body respond to high altitude
Definition
Hyperventilation
Term
How is the oxygen uptake vs. cardiac output relationship modified after training
Definition
None, the same relationship exists for trained and untrained
Term
Factors that cause increased cardiac output during exercise (3)
Definition
1) Tachycardia, 2) SNS activity, 3) Frank-Starling mechanism
Term
Factors that govern stroke volume (3)
Definition
1) Preload, 2) distensibility of the ventricles, 3) afterload
Term
Training affects stroke volume how at rest & during exercise
Definition
Higher at both rest and during exercise
Term
How does heart rate increase with oxygen uptake
Definition
Linearly then plateaus
Term
How does maximal heart rate change after training
Definition
It doesn't, maximum HR is about the same
Term
Training does what to heart rate at a given oxygen uptake
Definition
Training decreases heart rate for the same oxygen uptake
Term
For prolonged exercise, heart rate and stroke volume change due to what
Definition
Sweating
Term
How does sweating change heart rate
Definition
Increases it to maintain blood pressure from volume loss
Term
How does sweating change stroke volume
Definition
Decreases preload due to volume loss
Term
How does a-vO2 difference change with exercise
Definition
Oxygen difference increases with exercise due to greater oxygen extraction
Term
How does training affect a-vO2 difference at a given workload
Definition
It doesn't until at high levels then training increases the difference more
Term
How does the cardiac output fraction to skin change with workload
Definition
It slightly increases then slightly decreases to maintain blood pressure
Term
How does the cardiac output fraction to viscera change with workload
Definition
Steadily decreases with workload increase
Term
How does the cardiac output fraction to muscle change with workload
Definition
Increases steadily with workload increase
Term
How does the cardiac output fraction to the heart & lungs change with workload
Definition
Pretty much constant
Term
How does systolic pressure change with workload
Definition
Increases with workload increase
Term
How does mean arterial pressure change with workload
Definition
Increases with workload increase
Term
How does diastolic pressure change with workload
Definition
Same or slightly decreased with workload increase
Term
How does TPVR change with workload
Definition
Decreases with workload increase
Term
Which increases blood pressure: dynamic or isometric exercise
Definition
Isometric
Term
Which decreases blood pressure: dynamic or isometric exercise
Definition
Dynamic
Term
Who generally has a lower resting blood pressure: sedentary or trained
Definition
Trained have a lower resting BP
Term
Resistance training can __ [increase or decrease] resting blood pressure
Definition
Decrease
Term
Endurance training increases levels of what to increase blood volume (3)
Definition
1) ADH, 2) aldosterone, 3) plasma proteins
Term
How does minute ventilation increase with exercise (2)
Definition
1) Increased tidal volume, 2) increased respiratory rate
Term
How does tidal volume change with workload
Definition
Linear then plateaus
Term
How does respiratory rate change with workload
Definition
Linear then increases at a faster rate
Term
At a given oxygen uptake, which has a higher minute ventilation: trained or untrained
Definition
Untrained
Term
Which can achieve a higher maximum minute ventilation: trained or untrained
Definition
Trained
Term
Does pulmonary ventilation limit maximal oxygen: yes or no
Definition
No
Term
With increased workload, does VCO2 increase or decrease
Definition
Increase
Term
With increased workload, does [lactate] increase or decrease
Definition
Steady until after the anaerobic threshold then it increases
Term
With increased workload, does PaO2 increase or decrease
Definition
Steady until after the anaerobic threshold then it increases
Term
With increased workload, does PaCO2 increase or decrease
Definition
Decreases, especially after the anaerobic threshold
Term
With increased workload, does pH increase or decrease
Definition
Steady until after the anaerobic threshold then in decreases
Term
Why does PaO2 increase after anaerobic metabolism kicks in at the anaerobic threshold
Definition
Hyperventilation
Term
Hypoventilation: increase or decrease PaCO2
Definition
Increases
Term
Hypoventilation: increase or decrease PaO2
Definition
Decreases
Term
Hypoventilation: increase or decrease A-a PO2 difference
Definition
No change
Term
Does hypoxemia respond to oxygen therapy: yes or no
Definition
Yes
Term
Does hypoventilation respond to oxygen therapy: yes or no
Definition
Yes
Term
Does shunt respond to oxygen therapy: yes or no
Definition
No
Term
Shunt: increases or decreases PaO2
Definition
Decreases
Term
Shunt: increases or decreases A-a PO2 difference
Definition
Increases
Term
Does V/Q mismatch respond to oxygen therapy: yes or no
Definition
Yes
Term
V/Q mismatch: increases or decreases PaO2
Definition
Decreases
Term
V/Q mismatch: increases or decreases A-a PO2 difference
Definition
Increases
Term
Is V/Q mismatch more like __ [shunt or hypoventilation] on A-a PO2 difference
Definition
Shunt
Term
V/Q mismatch: increases or decreases minute ventilation
Definition
Increases
Term
Why do Ppl, Pao, Palv increase with inspiration on a ventilator
Definition
Mechanical ventilator works on positive pressure
Term
When lungs do not return to FRC during asthma, that is called
Definition
Auto-PEEP
Term
Auto-PEEP can occur with what diseases (2)
Definition
1) Asthma, 2) emphysema
Term
Auto-PEEP ultimately results in what happening to the thorax
Definition
It increases in volume
Term
Decreasing surfactant: __ [increases or decreases] FRC
Definition
Decreases
Term
Decreasing surfactant: __ [increases or decreases] tidal volume
Definition
Decreases
Term
Decreasing surfactant: __ [increases or decreases] respiratory rate
Definition
Increases
Term
Emphysema: __ [increases or decreases] FRC
Definition
Increases
Term
Emphysema: __ [increases or decreases] pleural pressure
Definition
Increases
Term
Emphysema: __ [increases or decreases] end expiratory volume
Definition
Increases [due to lack of elastic recoil]
Term
Increasing PEEP has effects on the heart similar to what CV condition
Definition
Hypovolemia
Term
Compared to normal, decreasing contractility does what to the Frank-Starling curve
Definition
Heart plateaus on a lower stroke volume (blue line)
Term
Compared to normal, increasing contractility does what to the Frank-Starling curve
Definition
Stroke volume increases for all LVEDP's (green line)
Term
What ultimately and abruptly puts an upper limit on end diastolic volumes
Definition
Fibrous pericardium ultimately prevents further filling [not in the simulation but a point worth making]
Term
When using a Swan-Ganz catheter, what changes when you enter the right ventricle
Definition
Significant jump in systolic pressure [4 to 30 mmHg]
Term
When using a Swan-Ganz catheter, what changes when you enter the pulmonary artery
Definition
Significant jump in diastolic pressure [4 to 13 mmHg]
Term
When using a Swan-Ganz catheter, what changes when catether wedges
Definition
Significant drop in systolic pressure
Term
Pulmonary capillary wedge pressure would __ [increase or decrease] after an LV infarction
Definition
Increase [infarction → decreased contractility → increased preload → increased LVEDP]
Term
Pulmonary capillary wedge pressure would __ [increase or decrease] after hemorrhage
Definition
Decrease [hemorrhage → decreased preload → decreased LVEDP]
Term
Pulmonary capillary wedge pressure would __ [increase or decrease] with mitral valve stenosis
Definition
Increase [prevents filling so atrial pressure would build up]
Term
Immediate result of adding blood volume
Definition
Increased preload
Term
Long-term result of adding blood volume
Definition
Increased preload and afterload shifts PV loop to the right with larger area
Term
Immediate result of increased TPVR
Definition
Increased afterload
Term
Long-term result of increased TPVR
Definition
Increased preload and afterload shifts PV loop to the right, and causes increased contractility so PV loop is taller
Term
Immediate result of increased contractility
Definition
Increases stroke volume to a lower LVESP
Term
Long-term result of increased contractility
Definition
Decreased preload and afterload shifts PV loop to the left
Term
Most striking features of aortic stenosis (2)
Definition
1) Isovolumetric relaxation phase is not isovolumetric, 2) much higher pressures
Term
Most striking features of aortic aortic regurgitation (2)
Definition
1) Isovolumetric relaxation phase is not isovolumetric, 2) higher preload
Term
Why is the pressure significantly higher with aortic stenosis
Definition
Stenotic valve adds considerable resistance → increased afterload → higher pressure required
Term
What causes the non-isovolumetric relaxation with regurgitation
Definition
Back-flow of blood from aorta into LV
Term
Shock
Definition
Systemic hypoperfusion that affects normal organ function
Term
Oxygen delivery (DO2) =
Definition
DO2 = cardiac output * arterial oxygen content = CO * CaO2
Term
Arterial oxygen content (CaO2) =
Definition
CaO2 = 1.39 * [Hgb] * SaO2 + 0.0003 * PaO2
Term
Normal hemoglobin level
Definition
5 g/dL
Term
Normal arterial oxygen content
Definition
21.2 mL/dL
Term
Situations in which dissolved O2 is physiological important (2)
Definition
1) Severe anemia, 2) hyperbaric chamber (possible to survive at 2.5 atm @ 100% O2)
Term
Normal DO2
Definition
1260 mL/min
Term
Normal VO2
Definition
3.5 mL/kg/min (70 kg → 250 mL/min)
Term
Which is normally larger: DO2 or VO2
Definition
DO2, by a wide margin
Term
Supply dependency
Definition
When DO2 no longer exceeds twice VO2
Term
As DO2 decreases, does ERO2 increase or decrease
Definition
Increases
Term
Normal ERO2
Definition
30%
Term
ERO2 =
Definition
ERO2 = (CaO2 - CvO2) / CaO2 = VO2/DO2
Term
Types of hypoxia (4)
Definition
1) Anemic, 2) hypoxic, 3) histotoxic, stagnant
Term
Type of hypoxia: hypoxia from anemia
Definition
Anemic hypoxia [brilliant, eh?]
Term
Type of hypoxia: severe pneumonia
Definition
Hypoxic hypoxia
Term
Type of hypoxia: inability to adequately oxygenate
Definition
Hypoxic hypoxia
Term
Type of hypoxia: cyanide poisoning
Definition
Histotoxic hypoxia
Term
Type of hypoxia: unable tot ake up or utilize oxygen
Definition
Histotoxic hypoxia
Term
Type of hypoxia: inadequate or maldistributed blood
Definition
Stagnant hypoxia
Term
Type of hypoxia: arterial thrombosis
Definition
Stagnant hypoxia
Term
Why does shock cause decreased urine output
Definition
Reduced renal perfusion
Term
Why does shock cause tachypnea
Definition
Acidosis
Term
Why does shock cause respiratory failure
Definition
Decreased diaphragm perfusion
Term
Why does shock cause cold, clammy skin
Definition
Low cardiac output → SNS activation
Term
Why does shock cause warm skin
Definition
High cardiac output → shunting of blood to skin
Term
Does shock guarantee low blood pressure: yes or no
Definition
No
Term
Why mechanically ventilate patients in shock
Definition
Breathing can consume up to 50% of VO2 to avoid acidemia
Term
Types of shock (3)
Definition
1) Hypovolemic, 2) cardiogenic, 3) distributive
Term
Type of shock: hemorrhage
Definition
Hypovolemic shock
Term
Type of shock: diarrhea
Definition
Hypovolemic shock
Term
Type of shock: dehydration
Definition
Hypovolemic shock
Term
Type of shock: decreased heart contractility
Definition
Cardiogenic shock
Term
Type of shock: pulmonary artery outflow obstruction (e.g., pulmonary embolism)
Definition
Cardiogenic shock
Term
Type of shock: acute mitral regurgitation
Definition
Cardiogenic shock
Term
Type of shock: sepsis
Definition
Distributive shock
Term
Type of shock: anaplaxis
Definition
Distributive shock
Term
Type of shock: liver failure
Definition
Distributive shock
Term
If lactate changes in shock, is it likely to increase or decrease
Definition
Increase
Term
If CvO2 changes in shock, is it likely to increase or decrease
Definition
Decrease
Term
Questions to ask in clinical assessment (3)
Definition
1) Is the CO reduced? 2) If so, is the heart too full? 3) What doesn't fit?
Term
How is cardiac output assessed at the bedside?
Definition
Pulse pressure as a surrogate for stroke volume (CO proportional to SV)
Term
Indications cardiac output may be reduced (6)
Definition
1) ↓ PP, 2) ↓ peripheral pulses, 3) ↓ extremity temp, 4) ↓ nail capillary refill, 5) muffled heart sounds, 6) chest pain, 7) diarrhea
Term
Assuming reduced CO: what does an S3 sound indicate: heart too full or not
Definition
Too full
Term
Assuming reduced CO: what does jugular venous distension indicate: heart too full or not
Definition
Too full
Term
Assuming reduced CO: what does cardiomegaly indicate: heart too full or not
Definition
Too full
Term
Assuming reduced CO: what does chest pain indicate: heart too full or not
Definition
Too full
Term
Assuming reduced CO: what does known heart disease indicate: heart too full or not
Definition
Too full
Term
Assuming reduced CO: what does dry mucous membranes indicate: heart too full or not
Definition
Not too full
Term
Assuming reduced CO: what does decreased skin turgor indicate: heart too full or not
Definition
Not too full
Term
Assuming reduced CO: what does hemorrhage indicate: heart too full or not
Definition
Not too full
Term
Assuming reduced CO: what does dehydration indicate: heart too full or not
Definition
Not too full
Term
Shock that goes untreated may become un-resolvable by Hippocrates himself, ths is called
Definition
Dysoxic shock
Term
Dysoxic shock
Definition
Un-resolvable shock
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